{"id":2747,"date":"2018-04-11T21:59:10","date_gmt":"2018-04-11T21:59:10","guid":{"rendered":"https:\/\/ccla.org\/?p=2747"},"modified":"2021-09-09T17:51:13","modified_gmt":"2021-09-09T17:51:13","slug":"assistance-medicale-a-mourir-ancien-projet-de-loi-c-14","status":"publish","type":"post","link":"https:\/\/ccla.org\/fr\/get-informed\/talk-rights\/medical-assistance-in-dying-former-bill-c-14\/","title":{"rendered":"Aide m\u00e9dicale \u00e0 mourir (ancien projet de loi C-14)"},"content":{"rendered":"\n\t\t<div id=\"fws_6a2f857b07a92\"  data-column-margin=\"default\" data-midnight=\"dark\"  class=\"wpb_row vc_row-fluid vc_row\"  style=\"padding-top: 0px; padding-bottom: 0px; \"><div class=\"row-bg-wrap\" data-bg-animation=\"none\" data-bg-animation-delay=\"\" data-bg-overlay=\"false\"><div class=\"inner-wrap row-bg-layer\" ><div class=\"row-bg viewport-desktop\"  style=\"\"><\/div><\/div><\/div><div class=\"row_col_wrap_12 col span_12 dark left\">\n\t<div  class=\"vc_col-sm-12 wpb_column column_container vc_column_container col no-extra-padding inherit_tablet inherit_phone \"  data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t\t<div class=\"wpb_wrapper\">\n\t\t\t\t\n\t\t<div id=\"fws_6a2f857b08a09\"  data-column-margin=\"default\" data-midnight=\"dark\"  class=\"wpb_row vc_row-fluid vc_row full-width-section\"  style=\"padding-top: 0px; padding-bottom: 0px; \"><div class=\"row-bg-wrap\" data-bg-animation=\"none\" data-bg-animation-delay=\"\" data-bg-overlay=\"true\"><div class=\"inner-wrap row-bg-layer\" ><div class=\"row-bg viewport-desktop\"  style=\"\"><\/div><\/div><div class=\"row-bg-overlay row-bg-layer\" style=\"background: rgba(0,0,0,0.3); background: linear-gradient(to bottom,rgba(0,0,0,0.3) 0%,rgba(238,238,238,0.01) 100%);  opacity: 0.5; \"><\/div><\/div><div class=\"row_col_wrap_12 col span_12 dark left\">\n\t<div  class=\"vc_col-sm-12 wpb_column column_container vc_column_container col no-extra-padding inherit_tablet inherit_phone \"  data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t\t<div class=\"wpb_wrapper\">\n\t\t\t\t<div class=\"divider-wrap\" data-alignment=\"default\"><div style=\"height: 10px;\" class=\"divider\"><\/div><\/div>\n\t\t\t<\/div> \n\t\t<\/div>\n\t<\/div> \n<\/div><\/div>\n\n\t\t\t<\/div> \n\t\t<\/div>\n\t<\/div> \n<\/div><\/div>\n\t\t<div id=\"fws_6a2f857b0a333\"  data-column-margin=\"default\" data-midnight=\"dark\" data-top-percent=\"4%\" data-bottom-percent=\"4%\"  class=\"wpb_row vc_row-fluid vc_row full-width-section post-links\"  style=\"padding-top: calc(100vw * 0.04); padding-bottom: calc(100vw * 0.04); \"><div class=\"row-bg-wrap\" data-bg-animation=\"none\" data-bg-animation-delay=\"\" data-bg-overlay=\"false\"><div class=\"inner-wrap row-bg-layer\" ><div class=\"row-bg viewport-desktop\"  style=\"\"><\/div><\/div><\/div><div class=\"row_col_wrap_12 col span_12 dark left\">\n\t<div  class=\"vc_col-sm-12 wpb_column column_container vc_column_container col no-extra-padding inherit_tablet inherit_phone \"  data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t\t<div class=\"wpb_wrapper\">\n\t\t\t\t<div class=\"divider-wrap\" data-alignment=\"default\"><div style=\"height: 30px;\" class=\"divider\"><\/div><\/div>\n<div class=\"wpb_text_column wpb_content_element \" >\n\t<div class=\"entry-meta\">\n<p><span class=\"posted-on\"><time class=\"entry-date published updated\" datetime=\"2018-04-11T16:21:46-04:00\">April 11, 2018<\/time><\/span><\/p>\n<\/div>\n<div class=\"shapely-content \">\n<p><em>Because the Learn section of TalkRights features content produced by CCLA volunteers and interviews with experts in their own words, opinions expressed here do not necessarily represent the CCLA\u2019s own policies or positions. For official publications, key reports, position papers, legal documentation, and up-to-date news about the CCLA\u2019s work\u00a0<a href=\"https:\/\/ccla.org\/?page_id=27\" target=\"_blank\" rel=\"noopener\">check out the In Focus section of our website.<\/a><\/em><\/p>\n<p>&nbsp;<\/p>\n<p>Much has changed since the Supreme Court\u2019s 2015 ruling in\u00a0<a href=\"https:\/\/scc-csc.lexum.com\/scc-csc\/scc-csc\/en\/item\/14637\/index.do\" target=\"_blank\" rel=\"noopener\"><em>Carter v Canada<\/em><\/a>. In this ruling, the court decided that the prohibition on physician assisted dying was unconstitutional and that assisted dying was a right to adults suffering from \u201cgrievous and irremediable\u201d medical illnesses.<a href=\"https:\/\/ccla.org\/29222\/#_ftn1\" name=\"_ftnref1\">[1]<\/a>\u00a0In response, parliament drafted and ratified Bill C-14,\u00a0<a href=\"https:\/\/www.canada.ca\/en\/health-canada\/services\/medical-assistance-dying.html\" target=\"_blank\" rel=\"noopener\"><em>Medical Assistance in Dying<\/em>.<\/a>\u00a0Since the bill was implemented in December 2015, over 2,150 people have undertaken a medically assisted death.<a href=\"https:\/\/ccla.org\/29222\/#_ftn2\" name=\"_ftnref2\">[2]<\/a>\u00a0While the ground-breaking law significantly changed Canada\u2019s end of life treatment, it is not without its controversies. Bill C-14\u2019s vague terms may prevent doctors from granting patients eligibility for fear of criminal charges. In addition, advanced requests for assisted dying are barred by this new law, meaning that those with Alzheimer\u2019s disease or dementia may be disqualified from receiving assisted death.<\/p>\n<p>&nbsp;<\/p>\n<h3><span style=\"color: #1e5799;\"><strong>Eligibility<\/strong><\/span><\/h3>\n<p>Those seeking assisted dying must meet\u00a0<em>all<\/em>\u00a0the following criteria specified in the Criminal Code:<\/p>\n<ul>\n<li>Must be 18 years of age or older<\/li>\n<li>Must be mentally competent and be able to make informed health care decisions independently at the time of the request<\/li>\n<li>Must have a grievous and irremediable medical condition, meaning one must:\n<ol>\n<li>Have a serious disease, illness or disability<\/li>\n<li>Be in an advanced state of decline that cannot be reversed<\/li>\n<li>Experience physical or mental suffering as a result of the medical condition that cannot be acceptably relieved<\/li>\n<li>Be at a point where natural death is reasonably foreseeable, though the condition does not need to be terminal or fatal.<\/li>\n<\/ol>\n<\/li>\n<li>Must give informed consent to receive assisted dying<\/li>\n<li>Two physicians or nurse practitioners must provide written opinions independently confirming that an individual is eligible for assisted dying<\/li>\n<li>The assisted dying request must be voluntary and not the result of outside pressure or influence\u00a0<a href=\"https:\/\/ccla.org\/29222\/#_ftn3\" name=\"_ftnref3\">[3]<\/a><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3><span style=\"color: #1e5799;\"><strong>How is assisted dying implemented:<\/strong><\/span><\/h3>\n<p>Once an individual has been deemed eligible, there are two types of medical assisted death. A physician or nurse practitioner may either directly administer a substance which causes death, or they may provide or prescribe a drug that a person may take themselves to bring about their own death.<a href=\"https:\/\/ccla.org\/29222\/#_ftn4\" name=\"_ftnref4\">[4]<\/a><\/p>\n<p>&nbsp;<\/p>\n<h3><span style=\"color: #1e5799;\"><strong>Reasonably foreseeable natural death:<\/strong><\/span><\/h3>\n<p>Bill C-14 requirement that the individual\u2019s natural death must be \u201creasonably foreseeable.\u201d This vague term has caused some contention. Parliament assures that the medical condition need not be terminal or fatal and that the term \u201creasonably foreseeable\u201d takes into account all medical circumstances and does not require a prognosis of how long one has left to live.<a href=\"https:\/\/ccla.org\/29222\/#_ftn5\" name=\"_ftnref5\">[5]<\/a>\u00a0Nevertheless, the term is vague and provides some difficultly for doctors and nurse practitioners evaluating an individual\u2019s eligibility for assisted dying.<\/p>\n<p>The case of\u00a0<em>A.B. v. Canada<\/em>\u00a0provides an apt example of how the vague phase of \u201creasonably foreseeable\u201d natural death can cause complications for those seeking assisted dying. AB was an 80-year-old cancer patient who suffered from uninterrupted and excruciating pain. Two physicians agreed that she met the criteria for assisted dying, thus making her eligible. Another physician, however, did not agree that AB\u2019s death was \u201creasonably foreseeable.\u201d Though AB technically qualified for assisted dying, no physician or nurse practitioner would assist AB in her death as they did not want to be liable for a criminal charge.<a href=\"https:\/\/ccla.org\/29222\/#_ftn6\" name=\"_ftnref6\">[6]<\/a><\/p>\n<p>The Ontario Superior Court ruled that though AB was eligible for assisted dying, it is not the court\u2019s role to make decisions for medical practitioners who are exclusively responsible for deciding whether the eligibility for assisted dying is met in each case. They also ruled that it was not the court\u2019s place to decide who is liable for criminal charges, a duty that lies in the prerogative of the Crown.<a href=\"https:\/\/ccla.org\/29222\/#_ftn7\" name=\"_ftnref7\">[7]<\/a>\u00a0The Court found that the term \u201cnatural death\u201d need not be connected to a particular terminal disease or condition and is instead connected to all of a particular person\u2019s medical circumstances.<a href=\"https:\/\/ccla.org\/29222\/#_ftn8\" name=\"_ftnref8\">[8]<\/a><\/p>\n<p>No physicians or medical practitioners have yet been criminally charged for administering assisted dying since Bill C-14\u2019s ratification. Yet, the vagueness of the term \u201creasonably foreseeable\u201d in Bill C-14 may prevent medical practitioners from assisting patients in death because they fear criminal repercussions.<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<h3><span style=\"color: #1e5799;\"><strong>Mental Illness and advanced requests:<\/strong><\/span><\/h3>\n<p>Bill C-14 requires that those seeking assisted dying provide informed consent and be mentally competent the time of their request. Because of this requirement, the bill prohibits advanced requests for assisted dying and patients with mental illness such as dementia and Alzheimer\u2019s disease may be ineligible to receive the service. An individual\u2019s eligibility would depend on the severity of their mental illness and if they are of sound mind at the time of the request. Questions have been raised by public interest groups concerning the constitutionality of this provision as it may \u201cunfairly discriminate against entire groups of desperately ill Canadians on the basis of their diagnoses.\u201d<a href=\"https:\/\/ccla.org\/29222\/#_ftn9\" name=\"_ftnref9\">[9]<\/a>\u00a0Yet, this constitutional challenge has not yet been tested in court.<\/p>\n<p>In Canada, there are about 564,000 people living with dementia, and 25,000 new cases are diagnosed each year.<a href=\"https:\/\/ccla.org\/29222\/#_ftn10\" name=\"_ftnref10\">[10]<\/a>\u00a0Clinical depression is a common symptom of patients suffering from dementia and Alzheimer\u2019s disease, affecting 30 to 50 per cent of those with Alzheimer\u2019s.<a href=\"https:\/\/ccla.org\/29222\/#_ftn11\" name=\"_ftnref11\">[11]<\/a>\u00a0If Canada were to implement measures allowing advanced requests for assisted dying to accommodate those suffering from dementia and Alzheimer\u2019s, it would not be the first nation to do so; Belgium the Netherlands and Luxemburg allow advanced choice in assisted dying.<a href=\"https:\/\/ccla.org\/29222\/#_ftn12\" name=\"_ftnref12\">[12]<\/a><\/p>\n<p>In December 2016, parliament announced that the federally-funded, independent\u00a0<a href=\"http:\/\/www.scienceadvice.ca\/en\/assessments\/in-progress\/medical-assistance-dying.aspx\" target=\"_blank\" rel=\"noopener\">Council for Canadian Academies<\/a>\u00a0is reviewing Bill C-14\u2019s issues of advanced requests, requests where mental illness is the sole condition, and requests by mature minors. The reports will not issue recommendations but will provide factual information, to be discussed in parliament.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>More Information:<\/strong><\/p>\n<p><a href=\"https:\/\/www.canada.ca\/en\/health-canada\/services\/medical-assistance-dying.html\" target=\"_blank\" rel=\"noopener\">Government of Canada<\/a><\/p>\n<p>Department of Justice:\u00a0<a href=\"http:\/\/www.justice.gc.ca\/eng\/cj-jp\/ad-am\/faq.html\" target=\"_blank\" rel=\"noopener\">Questions and Answers<\/a>\u00a0on Bill C-14<\/p>\n<p>College Of Physicians and Surgeons of Ontario:\u00a0<a href=\"http:\/\/www.cpso.on.ca\/CPSO\/media\/documents\/Policies\/Policy-Items\/medical-assistance-in-dying.pdf?ext=.pdf\" target=\"_blank\" rel=\"noopener\">Policy Statement<\/a><\/p>\n<p><a href=\"https:\/\/ccla.org\/?p=26331\" target=\"_blank\" rel=\"noopener\">CCLA\u2019s position on Bill C-14<\/a><\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/ccla.org\/29222\/#_ftnref1\" name=\"_ftn1\"><em><strong>[1]<\/strong><\/em><\/a><em>\u00a0Carter v. Canada (Attorney General)<\/em>, 2015 SCC 5, para 70.<\/p>\n<p><a href=\"https:\/\/ccla.org\/29222\/#_ftnref2\" name=\"_ftn2\">[2]<\/a>\u00a0Health Canada,\u00a0<em>2nd Interim Report on Medical Assistance in Dying in Canada<\/em>\u00a0(Ottawa:2017).<\/p>\n<p><a href=\"https:\/\/ccla.org\/29222\/#_ftnref3\" name=\"_ftn3\">[3]<\/a>\u00a0<em>Criminal Code<\/em>, RSC 2016, c C-27 s 241.2.<\/p>\n<p><a href=\"https:\/\/ccla.org\/29222\/#_ftnref4\" name=\"_ftn4\">[4]<\/a>\u00a0<em>Ibid,<\/em>\u00a0s 241.1.<\/p>\n<p><a href=\"https:\/\/ccla.org\/29222\/#_ftnref5\" name=\"_ftn5\">[5]<\/a>\u00a0<em>Ibid,\u00a0<\/em>s 241.2(2)(d).<\/p>\n<p><a href=\"https:\/\/ccla.org\/29222\/#_ftnref6\" name=\"_ftn6\">[6]<\/a>\u00a0<em>A.B. v Canada (Attorney General),<\/em>\u00a02016 ONSC 3759.<\/p>\n<p><a href=\"https:\/\/ccla.org\/29222\/#_ftnref7\" name=\"_ftn7\">[7]<\/a>\u00a0<em>Ibid,\u00a0<\/em>para 66-68.<\/p>\n<p><a href=\"https:\/\/ccla.org\/29222\/#_ftnref8\" name=\"_ftn8\">[8]<\/a><em>Ibid,<\/em>\u00a0para 81.<\/p>\n<p><a href=\"https:\/\/ccla.org\/29222\/#_ftnref9\" name=\"_ftn9\">[9]<\/a>\u00a0Dying with Dignity Canada, \u201cDying With Dignity Canada disappointed with Ottawa\u2019s approach to studying the future of Canada\u2019s assisted dying law\u201d, online: \u00a0&lt;http:\/\/www.dyingwithdignity.ca\/assisted_dying_independent_studies&gt;.<\/p>\n<p><a href=\"https:\/\/ccla.org\/29222\/#_ftnref10\" name=\"_ftn10\">[10]<\/a>\u00a0Alzheimer\u2019s Society Canada, \u201cDementia numbers in Canada\u201d, online: &lt;http:\/\/alzheimer.ca\/en\/Home\/About-dementia\/What-is-dementia\/Dementia-numbers&gt;.<\/p>\n<p><a href=\"https:\/\/ccla.org\/29222\/#_ftnref11\" name=\"_ftn11\">[11]<\/a>\u00a0J. Diehl-Schmid, R. Jox, S. Gauthier,\u00a0<em>et al.,<\/em>\u201c Suicide and assisted dying in dementia: what we know and what we need to know. A narrative literature review\u201d (2017) 29:8 International Psychogeriatrics 1247 at 1250.<\/p>\n<p><a href=\"https:\/\/ccla.org\/29222\/#_ftnref12\" name=\"_ftn12\">[12]<\/a>\u00a0<em>Ibid.<\/em><\/p>\n<\/div>\n<\/div>\n\n\n\n\n\t\t\t<\/div> \n\t\t<\/div>\n\t<\/div> \n<\/div><\/div>\n\t\t<div id=\"fws_6a2f857b0b73c\"  data-column-margin=\"default\" data-midnight=\"dark\"  class=\"wpb_row vc_row-fluid vc_row\"  style=\"padding-top: 0px; padding-bottom: 0px; \"><div class=\"row-bg-wrap\" data-bg-animation=\"none\" data-bg-animation-delay=\"\" data-bg-overlay=\"false\"><div class=\"inner-wrap row-bg-layer\" ><div class=\"row-bg viewport-desktop\"  style=\"\"><\/div><\/div><\/div><div class=\"row_col_wrap_12 col span_12 dark left\">\n\t<div  class=\"vc_col-sm-12 wpb_column column_container vc_column_container col no-extra-padding inherit_tablet inherit_phone \"  data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t\t<div class=\"wpb_wrapper\">\n\t\t\t\t\n\t\t<div id=\"fws_6a2f857b0cc72\"  data-column-margin=\"default\" data-midnight=\"dark\" data-top-percent=\"1%\" data-bottom-percent=\"1%\"  class=\"wpb_row vc_row-fluid vc_row\"  style=\"padding-top: calc(100vw * 0.01); padding-bottom: calc(100vw * 0.01); \"><div class=\"row-bg-wrap\" data-bg-animation=\"none\" data-bg-animation-delay=\"\" data-bg-overlay=\"false\"><div class=\"inner-wrap row-bg-layer\" ><div class=\"row-bg viewport-desktop\"  style=\"\"><\/div><\/div><\/div><div class=\"row_col_wrap_12 col span_12 dark left\">\n\t<div  class=\"vc_col-sm-12 wpb_column column_container vc_column_container col no-extra-padding inherit_tablet inherit_phone \"  data-padding-pos=\"all\" data-has-bg-color=\"false\" data-bg-color=\"\" data-bg-opacity=\"1\" data-animation=\"\" data-delay=\"0\" >\n\t\t<div class=\"vc_column-inner\" >\n\t\t\t<div class=\"wpb_wrapper\">\n\t\t\t\t<h3 style=\"color: #ef770e;text-align: left\" class=\"vc_custom_heading vc_do_custom_heading\" >About the Canadian Civil Liberties Association<\/h3>\n<div class=\"wpb_text_column wpb_content_element \" >\n\t<p>The CCLA is an independent, non-profit organization with supporters from across the country. Founded in 1964, the CCLA is a national human rights organization committed to defending the rights, dignity, safety, and freedoms of all people in Canada.<\/p>\n<\/div>\n\n\n\n<h3 style=\"color: #ef770e;text-align: left\" class=\"vc_custom_heading vc_do_custom_heading\" >For the Media<\/h3>\n<div class=\"wpb_text_column wpb_content_element \" >\n\t<p>For further comments, please contact us at\u00a0<a href=\"mailto:media@ccla.org\"><u>media@ccla.org<\/u><\/a>.<\/p>\n<\/div>\n\n\n\n<h3 style=\"color: #ef770e;text-align: left\" class=\"vc_custom_heading vc_do_custom_heading\" >For Live Updates<\/h3>\n<div class=\"wpb_text_column wpb_content_element \" >\n\t<p>Please keep referring to\u00a0<a href=\"https:\/\/ccla.org\/the-latest\/\" rel=\"noopener\">this page<\/a>\u00a0and to our social media platforms. We are on\u00a0<a href=\"https:\/\/www.instagram.com\/cancivlib\/?hl=en\" target=\"_blank\" rel=\"noopener\"><u>Instagram<\/u><\/a>,\u00a0<a href=\"http:\/\/facebook.com\/cancivlib\/\" target=\"_blank\" rel=\"noopener\"><u>Facebook<\/u><\/a>, <a href=\"https:\/\/twitter.com\/cancivlib\" target=\"_blank\" rel=\"noopener\"><u>Twitter<\/u><\/a>, <a href=\"https:\/\/ca.linkedin.com\/company\/canadian-civil-liberties-association\">LinkedIn<\/a> and <a href=\"https:\/\/bsky.app\/profile\/cancivlib.bsky.social\" target=\"_blank\" rel=\"noopener\"><u>BlueSky<\/u><\/a>.<\/p>\n<\/div>\n\n\n\n\n\t\t\t<\/div> \n\t\t<\/div>\n\t<\/div> \n<\/div><\/div>\n<style type=\"text\/css\" data-type=\"vc_shortcodes-default-css\">.vc_do_custom_heading{margin-bottom:0.625rem;margin-top:0;}.vc_do_custom_heading{margin-bottom:0.625rem;margin-top:0;}.vc_do_custom_heading{margin-bottom:0.625rem;margin-top:0;}<\/style>\n\t\t\t<\/div> \n\t\t<\/div>\n\t<\/div> \n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>L&#039;Association canadienne des libert\u00e9s civiles (ACLC) contestera l&#039;injonction exceptionnellement large du gouvernement de la Nouvelle-\u00c9cosse limitant les manifestations dans la province.<\/p>","protected":false},"author":14,"featured_media":5978,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[217,158],"tags":[],"class_list":["post-2747","post","type-post","status-publish","format-standard","has-post-thumbnail","category-tr-cases-laws","category-talk-rights"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - 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